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Pros and Cons of On-Premises, Cloud Hosted Healthcare Apps

Organizations need to consider the benefits and drawbacks of cloud hosted healthcare apps and on-premises apps before migrating certain workloads to the cloud

June 14, 2017 - Healthcare cloud computing becomes more popular each day but no entity currently has a fully cloud-based health IT infrastructure. Organizations must migrate applications to the cloud, choose which apps will perform better on-premise, and decide which are better suited for cloud hosted environments.

Organizations are opting to move certain applications to the cloud because they are easier to manage and are more flexible. However, hosting apps on-premises becomes expensive as organizations continue to deploy new apps and store more data.

It’s important to understand the benefits of on-premises applications before migrating apps to decide which apps are better off remaining in place. Several on-premises benefits also significantly contribute to why healthcare organizations are still hesitant to embrace the cloud.

The biggest benefit to on-premises applications is that the IT department has full control over the data stored on the application. For healthcare organizations in particular, control over the data is significant because many entities don’t trust cloud service providers to provide a fully HIPAA compliant PHI environment.

IT administrators also have full control over updating the application and are in control of outages and maintenance plans. On-premises applications are also not subject to vendor timelines for maintenance and updates.

Furthermore, on-premises applications can be accessed offline, which is especially key for mission critical applications in a healthcare setting. Clinicians still need access to applications in the event of an outage to care for patients in the emergency room or ICU.

The drawback of on-premises applications is that it takes a lot of time and expertise to manage and maintain an on-premises server. The organization is also responsible for all security protocols, maintenance, and hardware. Hiring the right staff to maintain a fully on-premises deployment and investing in the hardware required to support it can quickly become expensive.

Organizations also have to consider licenses and how expensive they can become as more apps are deployed. Open source platforms are an option, but they require customization and more IT staff to manage and maintain.

Organizations can also choose to host their applications in the cloud. However, cloud hosted applications come with its own set of benefits and drawbacks.

Cloud-based applications are much more flexible than their on-premises counterparts, which means it’s much less expensive to scale up when more space is needed. Organizations also have the opportunity to scale their cloud infrastructure back down if the space is no longer needed. This prevents overspending on hardware and investing in large data center gear.

Less on-premises infrastructure also speeds up deployment times. IT administrators have a more hands-off approach and can depend on the service provider for updates and maintenance.

The biggest drawback of cloud applications is that the data is no longer completely under the organization’s control. If an outage occurs, there’s nothing IT can do to get the apps back online faster.

Cloud service providers typically have contingency plans in place for a major outage, but if one does occur it can be devastating for a healthcare organization.

Cloud hosted applications are also dependent on network connectivity. Clinicians may not be able to reach their apps if there is a network outage or dead zones within an organization.

Entities are also putting security protocols into the cloud service provider’s hands with this approach. Many healthcare organizations are hesitant to do this because they wish to have full control over the PHI stored within the apps.

Organizations must review the benefits of apps moving to the cloud or keeping them on-premises. From there, entities decide which apps need to be moved.

Entities need to consider their current environment and determine which applications would better serve users if they were deployed in the cloud.

ClearSky Data CEO Ellen Rubin told HITInfratructure.com that healthcare organizations struggle to determine which data sets belong in the cloud and which are better off remaining on-premises.

“Healthcare organizations are living in this hybrid reality for the foreseeable future so they need to decide how they want to handle the portfolio of infrastructure,” Rubin stated. “That’s what entities are trying to figure out right now.”

“Some workloads will never go to the cloud,” she continued. “Some things can go and may keep primary production data in their data center but they’ll use the cloud for archival or backup. Organizations will be comfortable about certain workloads being built in the cloud and living there permanently.”

Entities typically start by moving low-end or smaller workloads and applications to build up confidence before migrating more sensitive or robust workloads. Those workloads that contain too much data may not be worth the trouble to migrate.

Healthcare organizations moving to cloud hosted solutions need to consider their current apps as well as how future apps will be deployed.

Utilizing both cloud and on-premises hosted applications gives entities the flexibility of cloud while maintaining the control and security of an on-premises deployment. Healthcare organizations need to remain educated on all available options and consider what resources they currently have along with what a reasonable future infrastructure deployment will look like. Finding the right balance between cloud and on-premises applications will keep data secure and costs manageable.